Swelling of the feet with heart disease

Diseases of the heart, in which patientsedema is observed, chronic heart failure, tahisystolic form of atrial fibrillation, tricuspid valve insufficiency, tricuspid stenosis, chronic compressive pericarditis, cardiomyopathy, amyloidosis of the heart.

Chronic characteristics of circulatory failure

Edema is one of the most important signschronic circulatory failure. Edema with chronic circulatory failure appear first on the legs, and then spread to the entire subcutaneous tissue *** (anasarca) ***.

The etiological factors of chroniccirculatory insufficiency (HNC) are myocardial diseases (myocarditis, myocardial dystrophy, cardiomyopathy), coronary heart disease, diffuse lung diseases, hypertension, heart defects, etc.

In chronic left ventricular failurealready at an early stage there are shortness of breath with normal loads and tachycardia associated with venous stasis in the lungs. With the progression of cardiac decompensation, dyspnea is associated with a cough. Over time, dyspnea becomes permanent. Characterized by "cold" cyanosis (different from the "warm" in pulmonary pathology).

With the progression of insufficiencyblood circulation edematous fluid appears in the cavities in the form of hydropericarditis, ascites. The appearance of edema is evidence of the development of right ventricular chronic failure, which often joins the left ventricular. In this case, the liver is gradually enlarged and compacted, its function is disrupted, the venous system is overflowing, which is manifested by swelling and pulsation of the cervical veins.

In connection with the development of stagnant phenomena in the gastrointestinal tract, there are dyspeptic disorders (nausea, flatulence, constipation).

Significantly impaired renal function, diuresis decreases, predominates nocturia.

Swelling of the subcutaneous tissue as it growsright ventricular failure become more persistent and significant and rise higher, extending to the hips, lower back, abdominal wall, in rare cases - to the upper limbs. Edema is prone to shifting downward, therefore, people who spend the day with their feet down, legs swell more, and in the lying patients - the area of ​​the sacrum. The accumulation of fluid occurs in the serous cavities. Hydrotorax can be bilateral or only right-sided. Ascites are observed more often with long-term right ventricular failure.

Diagnosis is based on dataclinical and instrumental research, the establishment of the underlying disease, which led to the development of heart failure. Informative electrocardiographic study, which allows you to establish changes in the myocardium and the volume of the heart cavities.

For early diagnosis of a latentheart failure is necessary to study hemodynamics in conditions of dosed physical exercise (Master's test, veloergometry, etc.) with the study of central hemodynamics with the help of rheography.

The phase analysis of cardiac activity with the help of polycardiography makes it possible to establish a hypodynamia syndrome, characteristic for the disturbance of the functional state of the myocardium.

Spirography reveals respiratoryinsufficiency, which is one of the earliest manifestations of chronic circulatory failure. When carrying out a sample with physical exertion, hyperventilation is established, inadequate to the fulfilled load. Right ventricular failure is confirmed by increased venous pressure, slowing blood flow